Laparoscopic cholecystectomy and cirrhosis: patient selection and technical considerations

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art_PINHEIRO_Laparoscopic_cholecystectomy_and_cirrhosis_patient_selection_and_technical_2017.PDF (658.26 KB)
Citações na Scopus
Tipo de produção
article
Data de publicação
2017
DOI
Web of Science
Título da Revista
ISSN da Revista
Título do Volume
Editora
AME PUBL CO
Autores
LAI, Quirino
Citação
ANNALS OF LAPAROSCOPIC AND ENDOSCOPIC SURGERY, v.2, article ID UNSP 35, 10p, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
The incidence of cholelithiasis in cirrhotic patients is higher than in general population. In the past, open cholecystectomy (OC) was the standard approach for patients requiring cholecystectomy. However, laparoscopic cholecystectomy (LC) was introduced in 1980's and gradually became the preferred technique even to cirrhotic patients. The performance of gastrointestinal surgery procedures in cirrhotics patients is well-known to be associated with higher technical difficulty and increased morbidity-mortality. Cirrhosis is a major key intraoperative finding that contributes to surgical difficulty in LC. Model of End Stage Liver Disease (MELD) score and Child-Pugh Classification are the best devices to evaluate the underlying liver disease and to predict morbidity-mortality. Acute cholecystitis has higher incidence in patients with cirrhosis, emergency procedures in cirrhotics patients are associated with higher morbidity, longer postoperative hospitalization and a seven-fold higher mortality in comparison to elective surgery. LC in cirrhotics has a higher conversion rate to open procedure; however, LC demonstrated substantial advantage over OC providing shorter convalescence period and hospital stay.
Palavras-chave
Cirrhosis, cholecystectomy, laparoscopy, morbidity, mortality
URI
https://observatorio.fm.usp.br/handle/OPI/30845
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/37